In most democratic countries, influential professional interest groups often become a part of the iron triangle in the policy making process. One of the typical methods by which professional interest groups participate in policy making process is by having interest group members in the national assembly, who is also sympathetic to the group, implement policies through legislation. In this study we found that from the Constitutional National Assembly to the 18th National Assembly, 147 members of the National Assembly of the Republic of Korea have been former health care professionals. The research analyzed the roles of these members in health care law amendments as requested by the professional organizations. This study analyzed 11 major cases that involved nullification or amendment of legislations in favor of the healthcare profession, against the basic policies of the government. The study showed that in the 11 major cases, policies were amended in the direction intended by the National Assembly members and other organizations with similar interests, which was against the policy stance of the government. However, these cases did not unilaterally imply that the National Assembly has been captured by the interest groups through the legislators with health care professional background; rather, they should be perceived to be influenced by the exhibited loss of governability by the government in respect to healthcare policy decisions, loss of initiative due to lack of controllability, and reversals and inconsistencies of the policies.
Delivery of Health Care* ; Iron ; Jurisprudence ; Policy Making* ; Public Opinion ; Republic of Korea ; Societies

BPH is found in 50% of males over the age of 50 and there is increase in incidence with age. But some patients with BPH do not induce bladder outlet obstruction and some patients with prostatism are not caused by bladder outlet obstruction. So, urodynamic study including pressure/flow study was performed in 45 males with prostatism to evaluate the degree of obstruction, and we measured maximal intravesical pressure, maximal detrusor pressure, prostatic urethral length, residual urine, minimal urethral resistance and pressure/flow plots. The 45 males were divided into 3 groups by maximal flow rate(MFR)(A: MFR>=15, B: 10<=MER<=15, C: MFR<10) and there was significant difference between each group only in minimal urethral resistance(P<0.05). The result of pressure/flow plots of A group showed that 93% (13/14) was nonobstructive pattern and the rest one was obstructive pattern which was caused by detrusor hyperreflexia. In B group. we could know the degree of obstruction in 58%(7/12) only with minimal urethral resistance and we could decide the degree of obstruction with pressure/flow plots in rest 5 cases whose minimal urethral resistances were between 0.43 and 0.65 unit. The result of pressure/flow plots of C group showed that 89%(17/19) was obstructive pattern and the rest 2 cases were nonobstructive patterns which were caused by detrusor hyporeflexia. In conclusion, with pressure/flow plots and minimal urethral resistance, we can decide the degree of obstruction in patients with prostatism especially whose MFR are between 10 and 15 ml/sec.
Humans ; Incidence ; Male ; Prostatism ; Reflex, Abnormal ; Urinary Bladder Neck Obstruction ; Urodynamics

An intestinal obstruction is a common cause of acute abdominal diseases which need emergency measures. Sigmoid volvulus is one of rare causes of colonic obstruction and occupies 2~3% of its causes in Korea. Volvulus requires a prompt diagnosis and decompression in order to prevent its progression to strangulation and gangrene. Although 90% of sigmoid volvulus can be diagnosed just by plain abdominal x-ray, computed tomography or barium enema can be done for more accurate diagnoses. For the successful treatment, accurate early examination, endoscopic reduction and surgical colonic resection are required. Endoscopic reduction has low mortality but is liable to recur, whereas emergency colonic resection has little recurrence rate but a high mortality. We experienced a case of a sigmoid volvulus in a 55-year-old male who companied of sudden abdominal pain. After diagnosed as sigmoid volvulus through plain abdominal x-ray and abdominal computed tomography, endoscopic reduction was done in the early period of development, and the sigmoid resection was performed after 7 days. We report our experience with a review of the literature regarding the diagnosis and treatment of sigmoid volvulus.
Abdominal Pain ; Barium ; Colon* ; Colon, Sigmoid* ; Decompression ; Diagnosis ; Emergencies* ; Enema ; Gangrene ; Humans ; Intestinal Obstruction ; Intestinal Volvulus* ; Korea ; Male ; Middle Aged ; Mortality ; Recurrence

PURPOSE: Hypertension is a common problem in maintenance hemodialysis (HD) patients. We assessed the effects of low sodium dialysate on changes of blood pressure in maintenance HD patients. METHODS: Forty HD patients were enrolled in this cross-over study. All the patients underwent nine consecutive HD sessions with the dialysate contained 138 mEq/L sodium (conventional sodium HD), then concentrations of sodium were switched to match the patients average pre-HD plasma sodium measured during the conventional sodium phase (135 mEq/L for patients with sodium levels less than 137, 137 for patients with sodium levels over 137). Dry weight and dialysis prescription were not modified during the six weeks of the study. RESULTS: There was a significant decrease in the interdialytic weight gain (2.4+/-0.9 kg vs. 2.0+/-0.7 kg, p<0.001) and the interdialytic thirsty in low sodium HD sessions compare to conventional sodium HD sessions. Pre-HD systolic and diastolic blood pressure (BP), post-dialysis systolic BP was similar in both periods of the study. The use of low sodium dialysate is associated with significantly lower systolic BP in patients with uncontrolled hypertension (n=10,157.1+/-3.6 mmHg vs. 148.0+/-9.4 mmHg, p=0.011), but not in those with controlled hypertension. Cardio-thoracic ratio was significant decrease in low sodium dialysate HD (0.53+/-0.08 vs. 0.51+/-0.07, p=0.002). The episodes of intradialytic hypotension and related symptoms were not more frequent in low sodium dialysate HD. CONCLUSION: Low dialysate sodium concentration based on predialysis sodium levels of patients could reduce the pre-HD systolic BP, interdialytic thirsty and interdialytic weight gain in maintenance HD patients.
Blood Pressure ; Cross-Over Studies ; Dialysis ; Humans ; Hypertension ; Hypotension ; Plasma ; Prescriptions ; Renal Dialysis ; Sodium ; Thirst ; Weight Gain

BACKGROUND: Nitric Oxide (NO) induced by NO synthase is known to be associated with hyperdynamic circulation and collateralization by vascular remodeling in patients with cirrhosis. METHODS: To assess the significance of peripheral NO activity in patients with cirrhosis, we measured the production of NO metabolites, nitrate and nitrite, using the nitrate/nitrite colorimetric assay with Griess reagents in the peripheral venous blood of 95 cirrhotic patients with or without clinical portal hypertension (PHT), and in the peripheral venous blood of 32 control patients without liver disease. RESULTS: The peripheral NO activities in cirrhotic patients with clinical PHT, cirrhotic patients without clinical PHT, and non-liver disease control patients were 86.1+/-40.6 micro mol/L, 83.5+/-47.2 micro mol/L and 52.3+/-38.4 micro mol/L, respectively. NO activity was significantly higher in cirrhotic patients than in non-liver disease control patients (p<0.05), while there was no significant difference of NO activity between the cirrhotic patients with or without clinical PHT. Peripheral NO activities in cirrhotic patients with Child-Pugh classification A, B, and C were 84.9+/-45.5 micro mol/L, 81.9+/-53.2 micro mol/L and 86.4+/-39.8 micro mol/L, respectively; these results were not significantly different. A significant correlation of NO activity with the biochemical profiles of the serum albumin level, bilirubin level and prothrombin time were not defined. CONCLUSIONS: Peripheral NO activity was increased in cirrhotic patients, but it did not reflect the degree of clinical portal hypertension and the function of the hepatic reserve in this study. For a precise analysis of the association of NO and hyperdynamic circulation with collateralization in cirrhosis, intrahepatic or portal NO activity might be considered rather than peripheral NO activity.
Bilirubin ; Classification ; Fibrosis ; Humans ; Hypertension, Portal ; Indicators and Reagents ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Nitric Oxide Synthase ; Nitric Oxide* ; Prothrombin Time ; Serum Albumin

PURPOSE: To report an epidemiologic study of keratoplasty in which we analyze basic data of corneal transplants and corneal donations in Korea. METHODS: From June 2004 through October 2004, questionnaires were distributed to 25 hospitals. The questionnaires were about the characteristics of patients registered in eye banks for keratoplasty from May 2001 to April 2003, and about the results of keratoplasties performed from May 2002 to April 2003. RESULTS: The leading corneal diseases in patients registered for keratoplasty were infectious keratitis (22.0%), trauma (21.0%), and pseudophakic and aphakic bullous keratopathy (13.8%), in that order. The leading indications in corneal recipients were: trauma (15.5%), pseudophakic and aphakic bullous keratopathy (13.7%), and infectious keratitis (10.7%), in that order. In 233 cases of keratoplasties, penetrating keratoplasty was performed in 229 cases (98.3%) and lamellar keratoplasty was performed in 4 cases (1.7%). The most common combined surgery was cataract extraction. Common causes of graft failure were rejection of donor cornea and infection. Imported donor corneas were used in sixty-one cases (26.2%) among the 233 total keratoplasties. CONCLUSIONS: We constructed an epidemiologic data base of patients registered for keratoplasty, corneal donation, and the results of keratoplasties throughout Korea.
Cataract Extraction ; Cornea ; Corneal Diseases ; Corneal Transplantation* ; Epidemiologic Studies* ; Eye Banks ; Humans ; Keratitis ; Keratoplasty, Penetrating ; Korea* ; Surveys and Questionnaires ; Tissue Donors ; Transplants

PURPOSE: To report an epidemiologic study of keratoplasty in which we analyze basic data of corneal transplants and corneal donations in Korea. METHODS: From June 2004 through October 2004, questionnaires were distributed to 25 hospitals. The questionnaires were about the characteristics of patients registered in eye banks for keratoplasty from May 2001 to April 2003, and about the results of keratoplasties performed from May 2002 to April 2003. RESULTS: The leading corneal diseases in patients registered for keratoplasty were infectious keratitis (22.0%), trauma (21.0%), and pseudophakic and aphakic bullous keratopathy (13.8%), in that order. The leading indications in corneal recipients were: trauma (15.5%), pseudophakic and aphakic bullous keratopathy (13.7%), and infectious keratitis (10.7%), in that order. In 233 cases of keratoplasties, penetrating keratoplasty was performed in 229 cases (98.3%) and lamellar keratoplasty was performed in 4 cases (1.7%). The most common combined surgery was cataract extraction. Common causes of graft failure were rejection of donor cornea and infection. Imported donor corneas were used in sixty-one cases (26.2%) among the 233 total keratoplasties. CONCLUSIONS: We constructed an epidemiologic data base of patients registered for keratoplasty, corneal donation, and the results of keratoplasties throughout Korea.
Cataract Extraction ; Cornea ; Corneal Diseases ; Corneal Transplantation* ; Epidemiologic Studies* ; Eye Banks ; Humans ; Keratitis ; Keratoplasty, Penetrating ; Korea* ; Surveys and Questionnaires ; Tissue Donors ; Transplants